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Zhang H, Xu L, Yang L, Su Z, Kang H, Xie X, He X, Zhang H, Zhang Q, Cao X, He X, Zhang T, Zhao F. Deep learning-based intratumoral and peritumoral features for differentiating ocular adnexal lymphoma and idiopathic orbital inflammation. Eur Radiol 2024:10.1007/s00330-024-11275-5. [PMID: 39702637 DOI: 10.1007/s00330-024-11275-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Revised: 10/16/2024] [Accepted: 11/07/2024] [Indexed: 12/21/2024]
Abstract
OBJECTIVES To evaluate the value of deep-learning-based intratumoral and peritumoral features for differentiating ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI). METHODS Nighty-seven patients with histopathologically confirmed OAL (n = 43) and IOI (n = 54) were randomly divided into training (n = 79) and test (n = 18) groups. DL-based intratumoral and peritumoral features were extracted to characterize the differences in heterogeneity and tissue invasion between different lesions, respectively. Subsequently, an attention-based fusion model was employed to fuse the features extracted from intra- and peritumoral regions and multiple MR sequences. A comprehensive comparison was conducted among different methods for extracting intratumoral, peritumoral, and fused features. Area under the curve (AUC) was used to evaluate the performance under a 10-fold cross-validation and independent test. Chi-square and student's t-test were used to compare discrete and continuous variables, respectively. RESULTS Fused intra-peritumoral features achieved AUC values of 0.870-0.930 and 0.849-0.924 on individual MR sequences in the validation and test sets, respectively. This was significantly higher than those using intratumoral features (p < 0.05), but not significantly different than those using peritumoral features (p > 0.05). By combining multiple MR sequences, AUC values of the intra-peritumoral features were boosted to 0.943 and 0.940, higher than those obtained from each sequence alone. Moreover, intra-peritumoral features yielded higher AUC values compared to entire orbital cone features extracted by either the intra- or the peritumoral DL model, although no significant difference was found from the latter (p > 0.05). CONCLUSION DL-based intratumoral, peritumoral, and especially fused intra-peritumoral features may help differentiate between OAL and IOI. KEY POINTS Question What is the diagnostic value of the peritumoral region and its combination with the intratumoral region for radiomic analysis of orbital lymphoproliferative disorders? Findings Fused intra- and peritumoral features achieved significantly higher performance than intratumoral features, but had no significant difference to the peritumoral features. Clinical relevance Peritumoral contextual features, which characterize the invasion patterns of orbital lesions within the surrounding areas of the entire orbital cone, might serve as an independent imaging marker for differentiating between OAL and IOI.
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Affiliation(s)
- Huachen Zhang
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China
| | - Li Xu
- Department of Computer Science and Technology, Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, China
| | - Lijuan Yang
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, China
| | - Zhiming Su
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China
| | - Haobei Kang
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China
| | - Xiaoyang Xie
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China
| | - Xuelei He
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China
| | - Hui Zhang
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, China
| | - Qiufang Zhang
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, China
| | - Xin Cao
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China
| | - Xiaowei He
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China
| | - Tao Zhang
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China.
| | - Fengjun Zhao
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology, Northwest University, Xi'an, China.
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O'Shaughnessy E, Senicourt L, Mambour N, Savatovsky J, Duron L, Lecler A. Toward Precision Diagnosis: Machine Learning in Identifying Malignant Orbital Tumors With Multiparametric 3 T MRI. Invest Radiol 2024; 59:737-745. [PMID: 38597586 DOI: 10.1097/rli.0000000000001076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
BACKGROUND Orbital tumors present a diagnostic challenge due to their varied locations and histopathological differences. Although recent advancements in imaging have improved diagnosis, classification remains a challenge. The integration of artificial intelligence in radiology and ophthalmology has demonstrated promising outcomes. PURPOSE This study aimed to evaluate the performance of machine learning models in accurately distinguishing malignant orbital tumors from benign ones using multiparametric 3 T magnetic resonance imaging (MRI) data. MATERIALS AND METHODS In this single-center prospective study, patients with orbital masses underwent presurgery 3 T MRI scans between December 2015 and May 2021. The MRI protocol comprised multiparametric imaging including dynamic contrast-enhanced (DCE), diffusion-weighted imaging (DWI), intravoxel incoherent motion (IVIM), as well as morphological imaging acquisitions. A repeated nested cross-validation strategy using random forest classifiers was used for model training and evaluation, considering 8 combinations of explanatory features. Shapley additive explanations (SHAP) values were used to assess feature contributions, and the model performance was evaluated using multiple metrics. RESULTS One hundred thirteen patients were analyzed (57/113 [50.4%] were women; average age was 51.5 ± 17.5 years, range: 19-88 years). Among the 8 combinations of explanatory features assessed, the performance on predicting malignancy when using the most comprehensive model, which is the most exhaustive one incorporating all 46 explanatory features-including morphology, DWI, DCE, and IVIM, achieved an area under the curve of 0.9 [0.73-0.99]. When using the streamlined "10-feature signature" model, performance reached an area under the curve of 0.88 [0.71-0.99]. Random forest feature importance graphs measured by the mean of SHAP values pinpointed the 10 most impactful features, which comprised 3 quantitative IVIM features, 4 quantitative DCE features, 1 quantitative DWI feature, 1 qualitative DWI feature, and age. CONCLUSIONS Our findings demonstrate that a machine learning approach, integrating multiparametric MRI data such as DCE, DWI, IVIM, and morphological imaging, offers high-performing models for differentiating malignant from benign orbital tumors. The streamlined 10-feature signature, with a performance close to the comprehensive model, may be more suitable for clinical application.
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Affiliation(s)
- Emma O'Shaughnessy
- From the Department of Neuroradiology, Rothschild Foundation Hospital, Paris, France (E.O.S., J.S., L.D., A.L.); Department of Data Science, Rothschild Foundation Hospital, Paris, France (L.S.); and Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France (N.M.)
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Ang T, Juniat V, Patel S, Selva D. Evaluation of orbital lesions with DCE-MRI: a literature review. Orbit 2024; 43:408-416. [PMID: 36437715 DOI: 10.1080/01676830.2022.2149819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/13/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE To provide a major review on the applications of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in evaluating orbital lesions. This review also outlines selected scenarios where DCE-MRI may be helpful. METHODS A comprehensive retrospective literature review of all English language publications on PubMed, EMBASE, and Google Scholar between 1994 and 2022. This literature review examined the specific applications and clinical scenarios surrounding the utility of DCE-MRI in orbital lesions and various findings that have been presented in the current literature. RESULTS DCE-MRI provides information on tissue physiology and permeability, beyond the anatomical features displayed on static imaging. Various measured parameters (qualitative, semi-quantitative, and quantitative) obtained by DCE-MRI have been used to differentiate between benign and malignant lesions, specific orbital lymphoproliferative diseases (OLPD), lacrimal gland lesions, and various rare orbital tumours. DCE-MRI has a limited role as an initial diagnostic imaging modality. However, DCE-MRI may prove to have benefit in predicting and monitoring treatment response in orbital lymphoma as a critical imaging study, but literature specific to orbital malignancies remains limited. CONCLUSION The value of DCE-MRI may be in situations of diagnostic uncertainty, where it may be an additional imaging aid following conventional imaging techniques. It may also act as a critical imaging modality for monitoring of orbital tumour treatment response, but the literature remains limited. Standardisation of imaging protocol, measured parameters, and statistical analysis remain limitations of this imaging technique.
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Affiliation(s)
- Terence Ang
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Valerie Juniat
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide South Australia, Australia
| | - Sandy Patel
- Department of Medical Imaging, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Dinesh Selva
- South Australian Institute of Ophthalmology, Royal Adelaide Hospital, Adelaide South Australia, Australia
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O'Shaughnessy E, Cossec CL, Mambour N, Lecoeuvre A, Savatovsky J, Zmuda M, Duron L, Lecler A. Diagnostic Performance of Dynamic Contrast-Enhanced 3T MR Imaging for Characterization of Orbital Lesions: Validation in a Large Prospective Study. AJNR Am J Neuroradiol 2024; 45:342-350. [PMID: 38453407 DOI: 10.3174/ajnr.a8131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/05/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND AND PURPOSE Orbital lesions are rare but serious. Their characterization remains challenging. Diagnosis is based on biopsy or surgery, which implies functional risks. It is necessary to develop noninvasive diagnostic tools. The goal of this study was to evaluate the diagnostic performance of dynamic contrast-enhanced MR imaging at 3T when distinguishing malignant from benign orbital tumors on a large prospective cohort. MATERIALS AND METHODS This institutional review board-approved prospective single-center study enrolled participants presenting with an orbital lesion undergoing a 3T MR imaging before surgery from December 2015 to May 2021. Morphologic, diffusion-weighted, and dynamic contrast-enhanced MR images were assessed by 2 readers blinded to all data. Univariable and multivariable analyses were performed. To assess diagnostic performance, we used the following metrics: area under the curve, sensitivity, and specificity. Histologic analysis, obtained through biopsy or surgery, served as the criterion standard for determining the benign or malignant status of the tumor. RESULTS One hundred thirty-one subjects (66/131 [50%] women and 65/131 [50%] men; mean age, 52 [SD, 17.1] years; range, 19-88 years) were enrolled. Ninety of 131 (69%) had a benign lesion, and 41/131 (31%) had a malignant lesion. Univariable analysis showed a higher median of transfer constant from blood plasma to the interstitial environment (K trans) and of transfer constant from the interstitial environment to the blood plasma (minute-1) (Kep) and a higher interquartile range of K trans in malignant-versus-benign lesions (1.1 minute-1 versus 0.65 minute-1, P = .03; 2.1 minute-1 versus 1.1 minute-1, P = .01; 0.81 minute-1 versus 0.65 minute-1, P = .009, respectively). The best-performing multivariable model in distinguishing malignant-versus-benign lesions included parameters from dynamic contrast-enhanced imaging, ADC, and morphology and reached an area under the curve of 0.81 (95% CI, 0.67-0.96), a sensitivity of 0.82 (95% CI, 0.55-1), and a specificity of 0.81 (95% CI, 0.65-0.96). CONCLUSIONS Dynamic contrast-enhanced MR imaging at 3T appears valuable when characterizing orbital lesions and provides complementary information to morphologic imaging and DWI.
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Affiliation(s)
- Emma O'Shaughnessy
- From the Department of Neuroradiology (E.O., J.S., L.D., A.L.), Rothschild Foundation Hospital, Paris, France
| | - Chloé Le Cossec
- Department of Clinical Research (C.L.C., A.L.), Rothschild Foundation Hospital, Paris, France
| | - Natasha Mambour
- Department of Ophthalmology (N.M., M.Z.), Rothschild Foundation Hospital, Paris, France
| | - Adrien Lecoeuvre
- Department of Clinical Research (C.L.C., A.L.), Rothschild Foundation Hospital, Paris, France
| | - Julien Savatovsky
- From the Department of Neuroradiology (E.O., J.S., L.D., A.L.), Rothschild Foundation Hospital, Paris, France
| | - Mathieu Zmuda
- Department of Ophthalmology (N.M., M.Z.), Rothschild Foundation Hospital, Paris, France
| | - Loïc Duron
- From the Department of Neuroradiology (E.O., J.S., L.D., A.L.), Rothschild Foundation Hospital, Paris, France
| | - Augustin Lecler
- From the Department of Neuroradiology (E.O., J.S., L.D., A.L.), Rothschild Foundation Hospital, Paris, France
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Gupta L, Peterson EL, Williams C, Altman E, Harpole R, Martin DJ, Escott EJ, Timoney PJ, Prendes MA. Diffusion-Weighted Imaging of the Orbit: A Case Series and Systematic Review. Ophthalmic Plast Reconstr Surg 2023; 39:407-418. [PMID: 36757844 DOI: 10.1097/iop.0000000000002325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
PURPOSE To describe the findings of diffusion-weighted imaging (DWI) for a series of orbital lesions and provide a systematic review of relevant literature. METHODS A retrospective review of 20 patients with orbital lesions who underwent MRI with DWI at two academic institutions between 2015 and 2020 was performed. Lesion diagnosis was histopathologically confirmed except a presumed cavernous hemangioma. Echoplanar diffusion-weighted images had been acquired using 2 or 3 b values (b=0 and 1000 or b=0, 500, and 1000) at 1.5T or 3T. Lesions with significant artifacts were excluded. DWI sequences were analyzed by neuro-radiologists blinded to the diagnosis. Mean ADC values of lesions were calculated from a single region of interest. An independent two-tailed t test was used to compare categories of lesions with p < 0.05 considered significant. A systematic review of the literature was performed. RESULTS Our study included 21 lesions. ADC values were significantly lower for malignant lesions (0.628 ± 0.125 × 10 -3 mm 2 /s) than inflammatory lesions (1.167 ± 0.381 × 10 -3 mm 2 /s) ( p < 0.001). ADC values were significantly lower for orbital lymphoma (mean 0.621 ± 0.147 × 10 -3 mm 2 /s) than idiopathic orbital inflammation (mean 1.188 ± 0.269 × 10 -3 mm 2 /s) with no overlap ( p < 0.001). CONCLUSIONS Orbital malignancies demonstrated lower ADC values, while inflammatory processes demonstrated higher ADC values, except IgG4-related disease. DWI and ADC values differentiated idiopathic orbital inflammation from orbital lymphoma. This study highlights the role of DWI in evaluating orbital pathology.
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Affiliation(s)
- Lalita Gupta
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio
| | - Eric L Peterson
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Cody Williams
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Emily Altman
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Ryan Harpole
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Douglas J Martin
- Department of Radiology, Case Western Reserve University, Cleveland, Ohio
| | - Edward J Escott
- Department of Radiology, Division of Neuroradiology, University of Kentucky Medical Center, Lexington, Kentucky
| | - Peter J Timoney
- Department of Ophthalmology, University of Kentucky, Lexington, Kentucky
| | - Mark A Prendes
- Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, Ohio
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Cameron CA, Tong JY, Juniat V, Patel S, Selva D. Diagnostic Utility of Diffusion-Weighted Imaging and Apparent Diffusion Coefficient for Common Orbital Lesions: A Review. Ophthalmic Plast Reconstr Surg 2022; 38:515-521. [PMID: 34798654 DOI: 10.1097/iop.0000000000002092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To review and summarize the existing literature surrounding the clinical use of diffusion-weighted imaging and apparent diffusion coefficient (ADC) as diagnostic tools in differentiating common orbital lesions. METHODS A systematic literature review on the use of ADC and diffusion-weighted imaging sequences for orbital imaging was performed. Only original research articles that reported ADC values for benign or malignant lesions were included. RESULTS Malignant orbital tumors have an overall lower mean ADC value than benign masses. Orbital lymphoma is characterized by consistently lower ADC values compared with other malignant orbital masses; a threshold value less than 0.775 × 10 -3 mm 2 /s has been proposed to distinguish orbital lymphoma from other neoplastic and non-neoplastic orbital masses. To differentiate orbital inflammatory disease from lymphoma, an ADC threshold greater than 0.92 × 10 -3 mm 2 /s has been proposed. CONCLUSIONS Orbital masses encompass a host of benign and malignant etiologies and can present a diagnostic challenge on both clinical and radiological assessment. Recent advanced MRI techniques such as diffusion-weighted imaging and ADC can improve the diagnostic specificity for orbital disease, particularly in differentiating benign from malignant lesions and lymphoma from orbital inflammatory disease.
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Affiliation(s)
- Cassie A Cameron
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
| | | | - Valerie Juniat
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
| | - Sandy Patel
- Department of Medical Imaging, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Dinesh Selva
- Discipline of Ophthalmology and Visual Sciences, The University of Adelaide and the South Australian Institute of Ophthalmology, Adelaide
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Lai KKH, Chu WCW, Li EYM, Chan RYC, Wei Y, Jia R, Cheng ACO, Chan KKW, Chin JKY, Kwok JSW, Io IYF, Yip NKF, Li KKW, Chan WH, Lam NM, Yip WWK, Young AL, Chan E, Ko CKL, Ko STC, Yuen HKL, Tham CCY, Pang CP, Chong KKL. Radiological Determinants of Complicated Immunoglobulin G4-Related Ophthalmic Disease: A Territory-Wide Cohort Study. Asia Pac J Ophthalmol (Phila) 2022; 11:417-424. [PMID: 36179335 DOI: 10.1097/apo.0000000000000552] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/10/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To evaluate the presenting radiological features of immunoglobulin G4-related ophthalmic disease (IgG4-ROD) and their associations with IgG4-related optic neuropathy (IgG4-RON), and IgG4-related ocular adnexal lymphoma (IgG4-ROL). METHODS A territory-wide, biopsy-proven, Chinese cohort. Masked review of orbital images, medical records, and histopathology reports. RESULTS A total of 115 (94%) of the 122 patients in our cohort had preoperative orbital images (computed tomography=105, magnetic resonance imaging=40). Among them, 103/115 (90%) showed enlarged lacrimal glands, and 91 (88%) were bilateral. Nerve enlargement was observed: infraorbital in 31/115 (27%) patients and frontal in 17/115 (15%), 10 and 9 being bilateral, respectively. At least 1 or more extraocular muscle (EOM) enlargement was found in 41/115 (37%) patients, bilaterally in 20. Lateral rectus occurred in 30 (73%) of these 41 EOM patients and inferior rectus in 28 (68%). Two adjacent EOMs (inferior and lateral recti in 11 patients, inferior and medial recti in 7 patients) or multiple EOMs (at least 3) were enlarged in 23/41 (56%) and 13/41 (32%) of the patients, respectively. Intraconal lesions (67% vs 11%, P<0.05), infraorbital (83% vs 23%, P<0.005), or frontal (50% vs 15%, P<0.05) nerve enlargement was significantly associated with IgG4-RON (6 patients) by univariate analyses. Asymmetric lacrimal gland enlargement and discrete orbital mass (both P<0.05) were associated with IgG4-ROL (9 patients) by multivariate analyses. CONCLUSIONS In this IgG4-ROD cohort, most patients had bilateral enlarged lacrimal glands, and the lateral rectus is the most frequently involved EOM. For the first time, unique radiological patterns associated with the development of IgG4-RON and IgG4-ROL are found.
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Affiliation(s)
- Kenneth K H Lai
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong SAR, China
| | - Winnie C W Chu
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong SAR, China
| | - Emmy Y M Li
- Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Regine Y C Chan
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Yingying Wei
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Ruofan Jia
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Andy C O Cheng
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong SAR, China
| | - Karen K W Chan
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Joyce K Y Chin
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Jeremy S W Kwok
- Department of Ophthalmology, Grantham Hospital, Hong Kong SAR, China
- Department of Ophthalmology, The University of Hong Kong, Hong Kong SAR, China
| | - Ida Y F Io
- Department of Ophthalmology, Caritas Medical Center, Hong Kong SAR, China
| | - Nelson K F Yip
- Department of Ophthalmology, United Christian Hospital, Hong Kong SAR, China
| | - Kenneth K W Li
- Department of Ophthalmology, United Christian Hospital, Hong Kong SAR, China
| | - Wai Ho Chan
- Department of Ophthalmology, Tuen Mun Hospital, Hong Kong SAR, China
| | - Nai Man Lam
- Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Wilson W K Yip
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Alvin L Young
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Edwin Chan
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong SAR, China
| | - Callie K L Ko
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong SAR, China
| | - Simon T C Ko
- Department of Ophthalmology, Tung Wah Eastern Hospital, Hong Kong SAR, China
| | - Hunter K L Yuen
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Clement C Y Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Kelvin K L Chong
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
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Yang L, Zhang H, Xie X, Jiang S, Zhang H, Cao X, Hou Y, He X, Wang J, Zhang T, Zhao F. MRI‐Based
Radiomics Nomogram for Preoperative Differentiation Between Ocular Adnexal Lymphoma and Idiopathic Orbital Inflammation. J Magn Reson Imaging 2022; 57:1594-1604. [PMID: 36053805 DOI: 10.1002/jmri.28404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI) are malignant and benign lesions for which radiotherapy and corticosteroids are indicated, but similar clinical manifestations make their differentiation difficult. PURPOSE To develop and validate an MRI-based radiomics nomogram for individual diagnosis of OAL vs. IOI. STUDY TYPE Retrospective. POPULATION A total of 103 patients (46.6% female) with mean age of 56.4 ± 16.3 years having OAL (n = 58) or IOI (n = 45) were divided into an independent training (n = 82) and a testing dataset (n = 21). FIELD STRENGTH/SEQUENCE A 3-T, precontrast T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and postcontrast T1WI (T1 + C). ASSESSMENT Radiomics features were extracted and selected from segmented tumors and peritumoral regions in MRI before-and-after filtering. These features, alone or combined with clinical characteristics, were used to construct a radiomics or joint signature to differentiate OAL from IOI, respectively. A joint nomogram was built to show the impact of the radiomics signature and clinical characteristics on individual risk of developing OAL. STATISTICAL TESTS Area under the curve (AUC) and accuracy (ACC) were used for performance evaluation. Mann-Whitney U and Chi-square tests were used to analyze continuous and categorical variables. Decision curve analysis, kappa statistics, DeLong and Hosmer-Lemeshow tests were also conducted. P < 0.05 was considered statistically significant. RESULTS The joint signature achieved an AUC of 0.833 (95% confidence interval [CI]: 0.806-0.870), slightly better than the radiomics signature with an AUC of 0.806 (95% CI: 0.767-0.838) (P = 0.778). The joint and radiomics signatures were comparable to experienced radiologists referencing to clinical characteristics (ACC = 0.810 vs. 0.796-0.806, P > 0.05) or not (AUC = 0.806 vs. 0.753-0.791, P > 0.05), respectively. The joint nomogram gained more net benefits than the radiomics nomogram, despite both showing good calibration and discriminatory efficiency (P > 0.05). DATA CONCLUSION The developed radiomics-based analysis might help to improve the diagnostic performance and reveal the association between radiomics features and individual risk of developing OAL. EVIDENCE LEVEL 3 TECHNICAL EFFICACY: 3.
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Affiliation(s)
- Lijuan Yang
- Department of Radiology Xi'an People's Hospital (Xi'an Fourth Hospital) Xi'an Shaanxi China
| | - Huachen Zhang
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology Northwest University Xi'an Shaanxi China
| | - Xiaoyang Xie
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology Northwest University Xi'an Shaanxi China
| | - Shijie Jiang
- Department of Radiology Xi'an People's Hospital (Xi'an Fourth Hospital) Xi'an Shaanxi China
| | - Hui Zhang
- Department of Radiology Xi'an People's Hospital (Xi'an Fourth Hospital) Xi'an Shaanxi China
| | - Xin Cao
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology Northwest University Xi'an Shaanxi China
| | - Yuqing Hou
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology Northwest University Xi'an Shaanxi China
| | - Xiaowei He
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology Northwest University Xi'an Shaanxi China
| | - Junming Wang
- Department of Radiology Xi'an People's Hospital (Xi'an Fourth Hospital) Xi'an Shaanxi China
| | - Tao Zhang
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology Northwest University Xi'an Shaanxi China
| | - Fengjun Zhao
- Xi'an Key Lab of Radiomics and Intelligent Perception, School of Information Science and Technology Northwest University Xi'an Shaanxi China
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9
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Sollmann N. Editorial for “Magnetic Resonance
Imaging‐Based
Radiomics Nomogram for Preoperative Differentiation Between Ocular Adnexal Lymphoma and Idiopathic Orbital Inflammation”. J Magn Reson Imaging 2022; 57:1605-1606. [PMID: 35986563 DOI: 10.1002/jmri.28405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/03/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology University Hospital Ulm Ulm Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine Klinikum rechts der Isar, Technical University of Munich Munich Germany
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10
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A deep learning model combining multimodal radiomics, clinical and imaging features for differentiating ocular adnexal lymphoma from idiopathic orbital inflammation. Eur Radiol 2022; 32:6922-6932. [PMID: 35674824 DOI: 10.1007/s00330-022-08857-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/10/2022] [Accepted: 05/01/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the value of deep learning (DL) combining multimodal radiomics and clinical and imaging features for differentiating ocular adnexal lymphoma (OAL) from idiopathic orbital inflammation (IOI). METHODS Eighty-nine patients with histopathologically confirmed OAL (n = 39) and IOI (n = 50) were divided into training and validation groups. Convolutional neural networks and multimodal fusion layers were used to extract multimodal radiomics features from the T1-weighted image (T1WI), T2-weighted image, and contrast-enhanced T1WI. These multimodal radiomics features were then combined with clinical and imaging features and used together to differentiate between OAL and IOI. The area under the curve (AUC) was used to evaluate DL models with different features under five-fold cross-validation. The Student t-test, chi-squared, or Fisher exact test was used for comparison of different groups. RESULTS In the validation group, the diagnostic AUC of the DL model using combined features was 0.953 (95% CI, 0.895-1.000), higher than that of the DL model using multimodal radiomics features (0.843, 95% CI, 0.786-0.898, p < 0.01) or clinical and imaging features only (0.882, 95% CI, 0.782-0.982, p = 0.13). The DL model built on multimodal radiomics features outperformed those built on most bimodalities and unimodalities (p < 0.05). In addition, the DL-based analysis with the orbital cone area (covering both the orbital mass and surrounding tissues) was superior to that with the region of interest (ROI) covering only the mass area, although the difference was not significant (p = 0.33). CONCLUSIONS DL-based analysis that combines multimodal radiomics features with clinical and imaging features may help to differentiate between OAL and IOI. KEY POINTS • It is difficult to differentiate OAL from IOI due to the overlap in clinical and imaging manifestations. • Radiomics has shown potential for noninvasive diagnosis of different orbital lymphoproliferative disorders. • DL-based analysis combining radiomics and imaging and clinical features may help the differentiation between OAL and IOI.
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Hu H, Chen L, Zhou J, Chen W, Chen HH, Zhang JL, Hsu YC, Xu XQ, Wu FY. Multiparametric magnetic resonance imaging for differentiating active from inactive thyroid-associated ophthalmopathy: Added value from magnetization transfer imaging. Eur J Radiol 2022; 151:110295. [DOI: 10.1016/j.ejrad.2022.110295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 04/01/2022] [Accepted: 04/03/2022] [Indexed: 11/03/2022]
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Pu J, Liang Y, He Q, Shao JW, Zhou MJ, Xiang ST, Li YW, Li JB, Ji SJ. Correlation Between IVIM-DWI Parameters and Pathological Classification of Idiopathic Orbital Inflammatory Pseudotumors: A Preliminary Study. Front Oncol 2022; 12:809430. [PMID: 35359367 PMCID: PMC8963367 DOI: 10.3389/fonc.2022.809430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Objective To investigate the correlation between intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) and the pathological classification of idiopathic orbital inflammatory pseudotumors (IOIPs). Methods Nineteen patients who were diagnosed with IOIPs (a total of 24 affected eyes) between November 2018 and December 2020 were included in the study. All the patients underwent magnetic resonance imaging orbital plain scans and IVIM-DWI multiparameter scans before an operation. The true diffusion coefficient (D), pseudodiffusion coefficient (D*), and perfusion fraction (f) values were obtained. Based on histopathology, the lesions were divided into three types: lymphocytic infiltration, fibrosclerotic, and mixed. The correlation between IVIM-DWI parameters and pathological classification was tested with the histopathological results as the gold standard. The data were analyzed using SPSS version 17.0, with P < 0.05 defined as significant. Results Among the 19 patients (24 eyes) affected by IOIP, there were no significant differences between IOIP pathological classification and gender or age (P > 0.05). There were statistically significant differences between the D and f values for different pathological types of IOIP and IVIM parameters (P < 0.05), and there was no significant difference in D* value between the different pathological types (P > 0.05). Conclusion The D and f values showed correlation with different types of IOIP, and the sensitivity of the D value was higher than that of the f value. The D* value showed no significant distinction between pathological types of IOIP.
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Affiliation(s)
- Jian Pu
- Radiology Department, Affiliated Hospital of Yunnan University, Kunming, China
| | - Yi Liang
- Radiology Department, Shaanxi Province Tumor Hospital, Xi’an, China
| | - Qian He
- Radiology Department, Affiliated Hospital of Yunnan University, Kunming, China
- *Correspondence: Qian He,
| | - Ju-Wei Shao
- Radiology Department, Affiliated Hospital of Yunnan University, Kunming, China
| | - Min-Jie Zhou
- Radiology Department, Affiliated Hospital of Yunnan University, Kunming, China
| | - Shu-Tian Xiang
- Radiology Department, Affiliated Hospital of Yunnan University, Kunming, China
| | - Ying-Wen Li
- Radiology Department, Affiliated Hospital of Yunnan University, Kunming, China
| | - Jian-Bo Li
- Radiology Department, Affiliated Hospital of Yunnan University, Kunming, China
| | - Shun-Jun Ji
- Medical Imaging, Kunming Medical University, Kunming, China
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Xiang S, Ren J, Xia Z, Yuan Y, Tao X. Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging in the differential diagnosis of parotid tumors. BMC Med Imaging 2021; 21:194. [PMID: 34920706 PMCID: PMC8684181 DOI: 10.1186/s12880-021-00724-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/26/2021] [Indexed: 01/18/2023] Open
Abstract
Objective Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) histograms were used to investigate whether their parameters can distinguish between benign and malignant parotid gland tumors and further differentiate tumor subgroups. Materials and methods A total of 117 patients (32 malignant and 85 benign) who had undergone DCE-MRI for pretreatment evaluation were retrospectively included. Histogram parameters including mean, median, entropy, skewness, kurtosis and 10th, 90th percentiles were calculated from time to peak (TTP) (s), wash in rate (WIR) (l/s), wash out rate (WOR) (l/s), and maximum relative enhancement (MRE) (%) mono-exponential models. The Mann–Whitney U test was used to compare the differences between the benign and malignant groups. The diagnostic value of each significant parameter was determined on Receiver operating characteristic (ROC) analysis. Multivariate stepwise logistic regression analysis was used to identify the independent predictors of the different tumor groups. Results For both the benign and malignant groups and the comparisons among the subgroups, the parameters of TTP and MRE showed better performance among the various parameters. WOR can be used as an indicator to distinguish Warthin’s tumors from other tumors. Warthin’s tumors showed significantly lower values on 10th MRE and significantly higher values on skewness TTP and 10th WOR, and the combination of 10th MRE, skewness TTP and 10th WOR showed optimal diagnostic performance (AUC, 0.971) and provided 93.12% sensitivity and 96.70% specificity. After Warthin’s tumors were removed from among the benign tumors, malignant parotid tumors showed significantly lower values on the 10th TTP (AUC, 0.847; sensitivity 90.62%; specificity 69.09%; P < 0.05) and higher values on skewness MRE (AUC, 0.777; sensitivity 71.87%; specificity 76.36%; P < 0.05). Conclusion DCE-MRI histogram parameters, especially TTP and MRE parameters, show promise as effective indicators for identifying and classifying parotid tumors. Entropy TTP and kurtosis MRE were found to be independent differentiating variables for malignant parotid gland tumors. The 10th WOR can be used as an indicator to distinguish Warthin’s tumors from other tumors.
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Affiliation(s)
- Shiyu Xiang
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Jiliang Ren
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Zhipeng Xia
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Ying Yuan
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Xiaofeng Tao
- Department of Radiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Shor N, Sené T, Zuber K, Zmuda M, Bergès O, Savatovsky J, Lecler A. Discriminating between IgG4-related orbital disease and other causes of orbital inflammation with intra voxel incoherent motion (IVIM) MR imaging at 3T. Diagn Interv Imaging 2021; 102:727-734. [PMID: 34326025 DOI: 10.1016/j.diii.2021.06.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/20/2021] [Accepted: 06/27/2021] [Indexed: 01/01/2023]
Abstract
PURPOSE The purpose of this prospective study was to determine the capabilities of intravoxel incoherent motion (IVIM) MRI at 3 Tesla in discriminating between IgG4-related orbital disease (IgG4-ROD) and other causes of orbital inflammation. MATERIALS AND METHODS Main selection criteria for the patients enrolled in this prospective study were age over 18 years and histopathologicaly proven orbital inflammatory lesion. MRI examinations were performed prior to surgery and treatment in all patients with suspected orbital inflammation. Two neuroradiologists, blinded to clinical data, independently analyzed structural MRI examinations and IVIM sequences obtained with 15 b values ranging from 0 to 2000 s/mm². Apparent diffusion coefficient (ADC), "true" diffusion coefficient (D), perfusion fraction (f) and pseudodiffusion coefficient (D*) values were calculated from all orbital lesions. Diagnostic capabilities of IVIM parameters were assessed using receiver operating-characteristic (ROC) curves and area under the curve (AUC). Sensitivity, specificity, and accuracy of IVIM parameters were calculated for the best threshold values and reported with their corresponding 95% confidence intervals (CI). RESULTS Thirty-five patients (21 women and 14 men; mean age, 49.2 ± 13.75 [SD] years; age range: 23-77 years) with 48 orbital lesions were enrolled in the study. Fifteen patients (15/35; 43%) had IgG4-ROD and 20 (20/35; 57%) had other causes of orbital inflammation. Median D value was significantly greater in patients with IgG4-ROD (1 × 10-3 mm2/s; interquartile range [IQR]: 0.9 × 10-3; 1.2 × 10-3) as compared to patients with non IgG4-ROD (0.80 × 10-3 mm2/s; IQR: 0.7 × 10-3; 1 × 10-3) (P = 0.04). There was no significant difference for ADC, f or D*. Area under the curve were of 0.54, 0.73, 0.63 and 0.56 for ADC, D, f and D*, respectively. Optimal threshold derived from ROC curves for D was 0.87 × 10-3 mm2/s, yielding 92% sensitivity (95% CI: 62-100%) and 71% specificity (95% CI: 44-90%) for the diagnosis of IgG4-ROD. No differences in standard morphological MRI criteria were found between IgG4-ROD and non IgG4-ROD. CONCLUSION Our study shows that IVIM MRI is a useful imaging technique to distinguish IgG4-ROD from other causes of orbital inflammation.
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Affiliation(s)
- Natalia Shor
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France; Department of Neuroradiology, Pitié-Salpêtriére Hospital, Assistance Publique-Hopitaux de Paris, 75013 Paris, France.
| | - Thomas Sené
- Department of Internal Medicine, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Kevin Zuber
- Department of Clinical Research, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Mathieu Zmuda
- Department of Orbitopalpebral Surgery, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Olivier Bergès
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Julien Savatovsky
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
| | - Augustin Lecler
- Department of Neuroradiology, Fondation Adolphe de Rothschild Hospital, 75019 Paris, France
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Chen W, Su GY, Zhou Y, Jiang JS, Jiang RH, Bao ML, Xu XQ, Wu FY. Longitudinal Multiparametric MRI Assessment of Irradiated Salivary Gland in a Rat Model: Correlated With Histological Findings. J Magn Reson Imaging 2021; 54:1730-1741. [PMID: 34278649 DOI: 10.1002/jmri.27836] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Several magnetic resonance imaging (MRI) sequences have been applied to assess injured glands but without histological validation. PURPOSE To evaluate longitudinal changes in multiparametric MRI (mp-MRI) of irradiated salivary glands in a rat model and investigate correlations between mp-MRI and histological findings. STUDY TYPE Prospective. ANIMAL MODEL Submandibular glands of 36 rats were radiated using a single dose of 15 Gy X-ray (irradiation [IR] group), and 6 other rats were enrolled into sham-IR group. mp-MRI were scanned 1 day after sham-IR (n = 6), or 1, 2, 4, 8, 12, 24 weeks after IR (n = 36, 6 per subgroup). FIELD STRENGTH/SEQUENCE A 3.0-T/Diffusion-weighted imaging (DWI), readout-segmented echo-planar imaging (EPI) sequence; intravoxel incoherent motion DWI, single-shot EPI sequence; T1 mapping, dual-flip-angle gradient-echo sequence with volumetric interpolated breath-hold examination; T2 mapping, turbo spin-echo sequence. ASSESSMENT Parameters including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D* ), perfusion fraction (f), T1 and T2 value were obtained. Histological examinations, including hematoxylin and eosin staining (for acinar cell fraction [AC%] detection), Masson's trichrome staining (for degree of fibrosis [F%] determination) and CD34-immunohistochemical staining (for microvessel density [MVD] calculation), were performed at corresponding time points. STATISTICAL TESTS One-way analysis of variance was used to compare the mp-MRI and histological parameters among different groups. Spearman correlation analysis was applied to determine the correlation between mp-MRI and histological parameters. Two-sided P ≤ 0.05 was considered statistically significant. RESULTS Changes of mp-MRI parameters (ADC, D, D* , f, T1, T2) and histological results (AC%, F%, MVD) among the seven groups were all significant. ADC, D, and T2 values negatively correlated with AC% (ADC, r = -0.728; D, r = -0.773; T2, r = -0.600), f positively correlated with MVD (r = 0.496), and T1 values positively correlated with F% (r = 0.714). DATA CONCLUSION: mp-MRI might be able to noninvasively and quantitatively evaluate the dynamic pathological changes within the irradiated salivary glands. EVIDENCE LEVEL 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Wei Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yan Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jia-Suo Jiang
- Department of Medical Imaging, Subei People's Hospital, Medical School of Yangzhou University, Yangzhou, China
| | - Run-Hao Jiang
- Department of Interventional Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mei-Ling Bao
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Su GY, Xu XQ, Zhou Y, Zhang H, Si Y, Shen MP, Wu FY. Texture analysis of dual-phase contrast-enhanced CT in the diagnosis of cervical lymph node metastasis in patients with papillary thyroid cancer. Acta Radiol 2021; 62:890-896. [PMID: 32757639 DOI: 10.1177/0284185120946711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Computed tomography texture analysis (CTTA) provides objective and quantitative information regarding tumor heterogeneity beyond visual inspection. However, no study has yet used CTTA to differentiate metastatic from non-metastatic cervical lymph node in patients with papillary thyroid cancer (PTC). PURPOSE To evaluate the value of texture analysis of dual-phase contrast-enhanced CT images in diagnosing cervical lymph node metastasis in patients with PTC. MATERIAL AND METHODS Metastatic (n = 27) and non-metastatic (n = 32) cervical lymph nodes were analyzed retrospectively. Texture analyses were performed on both arterial (A) and venous (V) phase CT images. Texture parameters, including mean gray-level intensity, skewness, kurtosis, entropy, and uniformity, were obtained and compared between groups. Receiver operating characteristic (ROC) curves analyses and multivariate logistic regression analysis were used in our study. RESULTS Metastatic lymph nodes showed significantly higher A-mean gray-level intensity, A-entropy, and lower A-kurtosis and V-kurtosis (all P < 0.001) than non-metastatic mimics. The ROC curve analyses indicated that A-kurtosis demonstrated an optimal diagnostic area under the curve (AUC; 0.884) and specificity (92.59%), while the A-mean gray-level intensity showed optimal diagnostic sensitivity (90.62%). Multivariate logistic regression analysis showed that A-mean gray-level intensity (P = 0.006, odds ratio [OR] = 24.297) and V-kurtosis (P = 0.014, OR = 19.651) were the independent predictor for metastatic cervical lymph node. CONCLUSION Dual-phase contrast-enhanced CCTA-especially A-mean gray-level intensity and V-kurtosis-may have the potential to diagnose metastatic cervical lymph node in patients with PTC.
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Affiliation(s)
- Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yan Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hao Zhang
- Department of Thyroid Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yan Si
- Department of Thyroid Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Mei-Ping Shen
- Department of Thyroid Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Tanenbaum RE, Lobo R, Kahana A, Wester ST. Advances in magnetic resonance imaging of orbital disease. Can J Ophthalmol 2021; 57:217-227. [PMID: 34058140 PMCID: PMC8627536 DOI: 10.1016/j.jcjo.2021.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 03/16/2021] [Accepted: 04/28/2021] [Indexed: 01/14/2023]
Abstract
Magnetic resonance imaging (MRI) is increasingly used by the orbital surgeon to aid in the diagnosis, surgical planning, and monitoring of orbital disease. MRI provides superior soft tissue detail compared with computed tomography or ultrasound, and advancing techniques enhance its ability to highlight abnormal orbital pathology. Diffusion-weighted imaging is a specialized technique that uses water molecule diffusion patterns in tissue to generate contrast signals and can help distinguish malignant from benign lesions. Steady-state free precession sequences such as Constructive Interference in Steady-State (CISS) and Fast Imaging Employing Steady-state Acquisition (FIESTA) generate highly detailed, 3-dimensional reconstructed images and are particularly useful in distinguishing structures adjacent to cerebral spinal fluid. Magnetic resonance angiography can be used to characterize vascular lesions within the orbit. New developments in magnetic field strength as well as the use of orbital surface coils achieve increasingly improved imaging resolution.
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Affiliation(s)
- Rebecca E Tanenbaum
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida
| | - Remy Lobo
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Alon Kahana
- Department of Ophthalmology, Oakland University William Beaumont School of Medicine, Rochester, Michigan; Consultants in Ophthalmic and Facial Plastic Surgery, Southfield, Michigan
| | - Sara T Wester
- Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida.
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To Explore MR Imaging Radiomics for the Differentiation of Orbital Lymphoma and IgG4-Related Ophthalmic Disease. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6668510. [PMID: 33628805 PMCID: PMC7884128 DOI: 10.1155/2021/6668510] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/29/2020] [Accepted: 01/23/2021] [Indexed: 12/28/2022]
Abstract
Among orbital lymphoproliferative disorders, about 55% of diagnosed cancerous tumors are orbital lymphomas, and nearly 50% of benign cases are immunoglobulin G4-related ophthalmic disease (IgG4-ROD). However, due to nonspecific characteristics, the differentiation of the two diseases is challenging. In this study, conventional magnetic resonance imaging-based radiomics approaches were explored for clinical recognition of orbital lymphomas and IgG4-ROD. We investigated the value of radiomics features of axial T1- (T1WI-) and T2-weighted (T2WI), contrast-enhanced T1WI in axial (CE-T1WI) and coronal (CE-T1WI-cor) planes, and 78 patients (orbital lymphoma, 36; IgG4-ROD, 42) were retrospectively reviewed. The mass lesions were manually annotated and represented with 99 features. The performance of elastic net-based radiomics models using single or multiple modalities with or without feature selection was compared. The demographic features showed orbital lymphoma patients were significantly older than IgG4-ROD patients (p < 0.01), and most of the patients were male (72% in the orbital lymphoma group vs. 23% in the IgG4-ROD group; p = 0.03). The MR imaging findings revealed orbital lymphomas were mostly unilateral (81%, p = 0.02) and wrapped eyeballs or optic nerves frequently (78%, p = 0.02). In addition, orbital lymphomas showed isointense in T1WI (100%, p < 0.01), and IgG4-ROD was isointense (60%, p < 0.01) or hyperintense (40%, p < 0.01) in T1WI with well-defined shape (64%, p < 0.01). The experimental comparison indicated that using CE-T1WI radiomics features achieved superior results, and the features in combination with CE-T1WI-cor features and the feature preselection method could further improve the classification performance. In conclusion, this study comparatively analyzed orbital lymphoma and IgG4-ROD from demographic features, MR imaging findings, and radiomics features. It might deepen our understanding and benefit disease management.
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Eissa L, Abdel Razek AAK, Helmy E. Arterial spin labeling and diffusion-weighted MR imaging: Utility in differentiating idiopathic orbital inflammatory pseudotumor from orbital lymphoma. Clin Imaging 2020; 71:63-68. [PMID: 33171369 DOI: 10.1016/j.clinimag.2020.10.057] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 09/26/2020] [Accepted: 10/26/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess arterial spin-labeling (ASL) and diffusion-weighted imaging (DWI) and in combination for differentiating between idiopathic orbital inflammatory pseudotumor (IOIP) and orbital lymphoma. MATERIAL AND METHODS A retrospective study was done on 37 untreated patients with orbital masses, suspected to be IOIP or orbital lymphoma that underwent ASL and DWI of the orbit. Quantitative measurement of tumor blood flow (TBF) and apparent diffusion coefficient (ADC) of the orbital lesion was done. RESULTS There was a significant difference (P = 0.001) in TBF between patients with IOIP (n = 21) (38.1 ± 6.2, 40.3 ± 7.1 ml/100 g/min) and orbital lymphoma (n = 16) (55.5 ± 7.1, 56.8 ± 7.9 ml/100 g/min) for both observers respectively. Thresholds of TBF used for differentiating IOIP from orbital lymphoma were 48, 46 ml/100 g/min revealed area under the curve (AUC) of (0.958 and 0.921), and accuracy of (86% and 83%) for both observers respectively. There was a significant difference (P = 0.001) in ADC between patients with IOIP (1.04 ± 0.19, 1.12 ± 0.23 × 10-3 mm2/s) and orbital lymphoma (0.69 ± 0.10, 0.72 ± 0.11 × 10-3 mm2/s) for both observers respectively. Thresholds of ADC used for differentiating IOIP from orbital lymphoma were 0.84 and 0.86 × 10-3 mm2/s with AUC of (0.933 and 0.920), and accuracy of 89% and 90% for both observers respectively. The combined TBF and ADC used for differentiating IOIP from orbital lymphoma had AUC of (0.973 and 0.970) and accuracy of (91% and 89%) for both observers respectively. CONCLUSION TBF and ADC alone and in combination are useful for differentiating IOIP from orbital lymphoma.
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Affiliation(s)
- Lamya Eissa
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
| | - Ahmed Abdel Khalek Abdel Razek
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
| | - Eman Helmy
- Department of Radiodiagnosis, Alexandria Faculty of Medicine, Alexandria, Egypt; Department of Diagnostic Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt
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Jiang H, Wang S, Li Z, Xie L, Wei W, Ma J, Xian J. Improving diagnostic performance of differentiating ocular adnexal lymphoma and idiopathic orbital inflammation using intravoxel incoherent motion diffusion-weighted MRI. Eur J Radiol 2020; 130:109191. [PMID: 32745898 DOI: 10.1016/j.ejrad.2020.109191] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/24/2020] [Accepted: 07/16/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the utility of intravoxel incoherent motion diffusion-weighted MRI (IVIM-DWI) derived diffusion and perfusion parameters in differentiating ocular adnexal lymphoma (OAL) from idiopathic orbital inflammation (IOI), and to assess whether IVIM-DWI provides improved diagnostic performance for the distinction. METHOD Twenty-one patients with OAL and 24 patients with IOI underwent IVIM-DWI. Apparent diffusion coefficient (ADC) and IVIM-DWI parameters including true diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were measured in lesions by two independent radiologists. The MRI parameter differences between OAL and IOI were tested using two-sample t-test. The receiver operating characteristic (ROC) analysis curves were used to determine the diagnostic performance of significant parameters for differentiation between OAL and IOI. RESULTS The ADC, D, and f were lower in OAL than those in IOI (ADC = 0.78 ± 0.12 vs. 0.99 ± 0.16 × 10-3 mm2/s, P < 0.001; D = 0.34 ± 0.15 vs. 0.76 ± 0.25 × 10-3 mm2/s, P < 0.001; f = 0.31 ± 0.06 vs. 0.41 ± 0.08 × 100 %, P < 0.001). There was no significant difference in D* between OAL and IOI (P = 0.235). The optimal cut-off values of ADC, D, and f in differentiating OAL from IOI were 0.83 × 10-3 mm2/s, 0.56 × 10-3 mm2/s, and 0.36 × 100 %, respectively. No significant differences were found in areas under the curve (AUCs) among ADC, D and f (all P > 0.05). The combination of D and f provided significantly higher AUC than ADC (AUC = 0.984 vs. 0.838, Z = 2.128, P = 0.033), and had higher sensitivity of 95.24 %, specificity of 95.83 %, and accuracy of 95.56 %. CONCLUSIONS IVIM-DWI is valuable in differentiating OAL from IOI, and D combined f can improve the performance of differential diagnosis.
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Affiliation(s)
- Hong Jiang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China
| | - Shijun Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China
| | - Zheng Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China
| | | | - Wenbin Wei
- Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China; Beijing Key Lab. of Intraocular Tumor Diagnosis and Treatment, Beijing 100730, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Jianmin Ma
- Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China; Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China; Clinical Center for Eye Tumors, Capital Medical University, Beijing 100730, China.
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Hou Y, Xie X, Chen J, Lv P, Jiang S, He X, Yang L, Zhao F. Bag-of-features-based radiomics for differentiation of ocular adnexal lymphoma and idiopathic orbital inflammation from contrast-enhanced MRI. Eur Radiol 2020; 31:24-33. [PMID: 32789530 DOI: 10.1007/s00330-020-07110-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/04/2020] [Accepted: 07/23/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of bag-of-features (BOF)-based radiomics for differentiating ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI) from contrast-enhanced MRI (CE-MRI). METHODS Fifty-six patients with pathologically confirmed IOI (28 patients) and OAL (28 patients) were randomly divided into training (n = 42) and testing (n = 14) groups. One hundred sixty texture features extracted from the CE-MR image were encoded into the BOF representation with fewer features. The support vector machine (SVM) with a linear kernel was used as the classifier. Data augmented was performed by cropping orbital lesions in different directions to alleviate the over-fitting problem. Student's t test and the Holm-Bonferroni method were employed to compare the performance of different analysis methods. The chi-square test was used to compare the analysis with MRI and human radiological diagnosis. RESULTS In the independent testing group, the differentiation by the BOF features with augmentation achieved an area under the curve (AUC) of 0.803 (95% CI: 0.725-0.880), which was significantly higher than that of the BOF features without augmentation and that of the texture features (p < 0.05). In addition, the same radiomic analysis with pre-contrast MRI obtained an AUC of 0.618 (95% CI: 0.560-0.677), which was significantly lower than that with CE-MRI. The diagnostic performance of the analysis with CE-MRI was significantly better than the radiology resident (p < 0.05) but had no significant difference with the experienced radiologist, even though there was less consistency between the radiomic analysis and the human visual diagnosis. CONCLUSIONS The BOF-based radiomics may be helpful for the differentiation between OAL and IOI. KEY POINTS • It is challenging to differentiate OAL from IOI due to the similar clinical and image features. • Radiomics has great potential for the noninvasive diagnosis of orbital diseases. • The BOF representation from patch to image may help the differentiation of OAL and IOI.
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Affiliation(s)
- Yuqing Hou
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Xiaoyang Xie
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Jixin Chen
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Peng Lv
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, 710004, Shaanxi, China
| | - Shijie Jiang
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, 710004, Shaanxi, China
| | - Xiaowei He
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China.,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China
| | - Lijuan Yang
- Department of Radiology, Xi'an Fourth Hospital, Xi'an, 710004, Shaanxi, China.
| | - Fengjun Zhao
- School of Information Science and Technology, Northwest University, Xi'an, 710069, Shaanxi, China. .,Xi'an Key Lab of Radiomics and Intelligent Perception, Northwest University, Xi'an, 710069, Shaanxi, China.
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22
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Intravoxel incoherent motion (IVIM) 3 T MRI for orbital lesion characterization. Eur Radiol 2020; 31:14-23. [PMID: 32740820 DOI: 10.1007/s00330-020-07103-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 04/28/2020] [Accepted: 07/22/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To determine the diagnostic accuracy of MRI intravoxel incoherent motion (IVIM) when characterizing orbital lesions, which is challenging due to a wide range of locations and histologic types. METHODS This IRB-approved prospective single-center study enrolled participants presenting with an orbital lesion undergoing a 3-T MRI prior to surgery from December 2015 to July 2019. An IVIM sequence with 15 b values ranging from 0 to 2000 s/mm2 was performed. Two neuroradiologists, blinded to clinical data, individually analyzed morphological MRIs. They drew one region of interest inside each orbital lesion, providing apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) values. T test, Mann-Whitney U test, and receiver operating characteristic curve analyses were performed to discriminate between orbital lesions and to determine the diagnostic accuracy of the IVIM parameters. RESULTS One hundred fifty-six participants (84 women and 72 men, mean age 54.4 ± 17.5 years) with 167 orbital lesions (98/167 [59%] benign lesions including 54 orbital inflammations and 69/167 [41%] malignant lesions including 32 lymphomas) were included in the study. ADC and D were significantly lower in malignant than in benign lesions: 0.8 × 10-3 mm2/s [0.45] versus 1.04 × 10-3 mm2/s [0.33], p < 0.001, and 0.75 × 10-3 mm2/s [0.40] versus 0.98 × 10-3 mm2/s [0.42], p < 0.001, respectively. D* was significantly higher in malignant lesions than in benign ones: 12.8 × 10-3 mm2/s [20.17] versus 7.52 × 10-3 mm2/s [7.57], p = 0.005. Area under curve was of 0.73, 0.74, 0.72, and 0.81 for ADC, D, D*, and a combination of D, f, and D*, respectively. CONCLUSIONS Our study showed that IVIM might help better characterize orbital lesions. KEY POINTS • Intravoxel incoherent motion (IVIM) helps clinicians to assess patients with orbital lesions. • Intravoxel incoherent motion (IVIM) helps clinicians to characterize orbital lymphoma versus orbital inflammation. • Management of patients becomes more appropriate.
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23
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Jiang JS, Zhu LN, Chen W, Chen L, Su GY, Xu XQ, Wu FY. Added value of susceptibility-weighted imaging to diffusion-weighted imaging in the characterization of parotid gland tumors. Eur Arch Otorhinolaryngol 2020; 277:2839-2846. [PMID: 32328768 DOI: 10.1007/s00405-020-05985-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 04/13/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess the added value of susceptibility-weighted imaging (SWI) to diffusion-weighted imaging (DWI) in the characterization of parotid gland tumors. METHODS Seventy-eight patients with pathologically confirmed parotid gland tumors, who underwent DWI and SWI for pre-surgery evaluation, were enrolled. Apparent diffusion coefficient (ADC) and degree of intratumoral susceptibility signal intensity (ITSS) were measured and compared between benign and malignant groups, and among pleomorphic adenoma (PA), Warthin tumor (WT) and malignant tumor (MT). Independent sample t test, one-way analysis of variance and receiver operating characteristic curve analysis were used for statistical analyses. RESULTS Benign parotid gland tumor showed a significantly higher mean ADC value than malignant tumors (0.836 ± 0.350 vs 0.592 ± 0.163, p = 0.001). Setting an average ADC value of 0.679 as the cut-off value, optimal differentiating performance could be obtained (AUC, 0.700; sensitivity, 62.69%; specificity, 81.82%) for differentiating malignant from benign tumors. PA showed significantly higher mean ADC and less ITSS than WT (ADC, p < 0.001; ITSS, p = 0.033) and MT (ADC, p < 0.001; ITSS, p = 0.024), while the difference between WT and MT was not significant (ADC, p = 0.826; ITSS, p = 0.539). After integration with ITSS, the diagnostic performance of ADC was improved for differentiating PA from WT (AUC 0.921 vs 0.873) and from MT (AUC 0.906 vs 0.882). CONCLUSION SWI could provide added information to DWI and serve as a supplementary imaging marker for the characterization of parotid gland tumors.
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Affiliation(s)
- Jia-Suo Jiang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, People's Republic of China
| | - Liu-Ning Zhu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Wei Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, People's Republic of China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, People's Republic of China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, People's Republic of China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, People's Republic of China.
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd., Nanjing, People's Republic of China.
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24
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Shen J, Xue L, Zhong Y, Wu YL, Zhang W, Yu TF. Feasibility of using dynamic contrast-enhanced MRI for differentiating thymic carcinoma from thymic lymphoma based on semi-quantitative and quantitative models. Clin Radiol 2020; 75:560.e19-560.e25. [PMID: 32197918 DOI: 10.1016/j.crad.2020.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 02/18/2020] [Indexed: 01/02/2023]
Abstract
AIM To evaluate the value of using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) derived parameters to differentiate thymic carcinoma and thymic lymphoma based on semi-quantitative and quantitative models. MATERIALS AND METHODS Twenty-nine pathologically confirmed anterior mediastinum tumours in 29 patients were enrolled in this retrospective study, including 15 thymic carcinoma and 14 lymphoma patients. All the patients underwent pre-treatment mediastinum DCE-MRI. Both semi-quantitative and quantitative parameters were calculated and the volume transfer constant Ktrans, the flux rate constant between extravascular extracellular space and plasma kep, the extravascular extracellular volume fraction ve were obtained based on a modified Tofts model. DCE-MRI derived parameters were compared between thymic carcinoma and thymic lymphoma groups. RESULTS Thymic carcinoma had significantly lower kep (p=0.040) and higher ve (p=0.018) than thymic lymphoma; however, there were no significant differences on Ktrans and semi-quantitative parameters between the two groups. ve had the highest area under the curve (cut-off value, 0.282; area under the curve, 0.748; sensitivity, 71.4%; specificity, 80%). The combination of kep and ve could increase the diagnostic performance significantly (area under the curve, 0.752; sensitivity, 57.1%; specificity, 93.3%). CONCLUSION DCE-MRI derived parameters may have value in the differentiating thymic carcinoma and thymic lymphoma.
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Affiliation(s)
- J Shen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - L Xue
- Department of Thoracic Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Y Zhong
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Y-L Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - W Zhang
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - T-F Yu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Lecler A, Balvay D, Cuenod C, Marais L, Zmuda M, Sadik J, Galatoire O, Farah E, El Methni J, Zuber K, Bergès O, Savatovsky J, Fournier L. Quality‐based pharmacokinetic model selection on DCE‐MRI for characterizing orbital lesions. J Magn Reson Imaging 2019; 50:1514-1525. [DOI: 10.1002/jmri.26747] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/15/2019] [Accepted: 03/18/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Augustin Lecler
- Department of NeuroradiologyFoundation Adolphe de Rothschild Hospital Paris France
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR‐S970Cardiovascular Research Center – PARCC Paris France
| | - Daniel Balvay
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR‐S970Cardiovascular Research Center – PARCC Paris France
| | - Charles‐André Cuenod
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR‐S970Cardiovascular Research Center – PARCC Paris France
- Radiology Department, Hôpital Européen Georges PompidouUniversité Paris Descartes Sorbonne Paris Cité, Assistance Publique‐Hôpitaux de Paris Paris France
| | - Louise Marais
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR‐S970Cardiovascular Research Center – PARCC Paris France
| | - Mathieu Zmuda
- Department of Orbitopalpebral SurgeryFoundation Adolphe de Rothschild Hospital Paris France
| | - Jean‐Claude Sadik
- Department of NeuroradiologyFoundation Adolphe de Rothschild Hospital Paris France
| | - Olivier Galatoire
- Department of Orbitopalpebral SurgeryFoundation Adolphe de Rothschild Hospital Paris France
| | - Edgar Farah
- Department of Orbitopalpebral SurgeryFoundation Adolphe de Rothschild Hospital Paris France
| | - Jonathan El Methni
- MAP5, UMR CNRS 8145Université Paris Descartes Sorbonne Paris Cité France
| | - Kevin Zuber
- Department of Clinical ResearchFoundation Adolphe de Rothschild Hospital Paris France
| | - Olivier Bergès
- Department of NeuroradiologyFoundation Adolphe de Rothschild Hospital Paris France
| | - Julien Savatovsky
- Department of NeuroradiologyFoundation Adolphe de Rothschild Hospital Paris France
| | - Laure Fournier
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR‐S970Cardiovascular Research Center – PARCC Paris France
- Radiology Department, Hôpital Européen Georges PompidouUniversité Paris Descartes Sorbonne Paris Cité, Assistance Publique‐Hôpitaux de Paris Paris France
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Xu XQ, Hu H, Su GY, Liu H, Wu FY, Shi HB. Differentiation between orbital malignant and benign tumors using intravoxel incoherent motion diffusion-weighted imaging: Correlation with dynamic contrast-enhanced magnetic resonance imaging. Medicine (Baltimore) 2019; 98:e14897. [PMID: 30896639 PMCID: PMC6709032 DOI: 10.1097/md.0000000000014897] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
To evaluate the performance of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) for differentiating orbital malignant from benign tumors, and to assess the correlation between IVIM-DWI parameters and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters.Twenty-seven patients (17 benign and 10 malignant) with orbital tumors underwent 3.0T MRI examination for pre-treatment evaluation, including IVIM-DWI and DCE-MRI. IVIM-DWI parameters (tissue diffusivity, D; pseudo-diffusion coefficient, D; and perfusion fraction, f) were quantified using bi-exponential fitting model. DCE-MRI parameters (K, the volume transfer constant between the plasma and the extracellular extravascular space [EES]; Ve, the volume fraction of the EES, and Kep, the rate constant from EES to blood plasma) were quantified using modified Tofts model. Independent-sample t test, receiver operating characteristic curve analyses and Spearman correlation test were used for statistical analyses.Malignant orbital tumors showed lower D (P <.001) and higher D (P = .002) than benign tumors. Setting a D value of 0.966 × 10 mm/s as the cut-off value, a diagnostic performance (AUC, 0.888; sensitivity, 100%; specificity, 82.35%) could be obtained for diagnosing malignant tumors. While setting a D value of 42.371 × 10 mm/s as cut-off value, a diagnostic performance could be achieved (AUC, 0.847; sensitivity, 90.00%; specificity, 70.59%). Poor or moderated correlations were found between IVIM-DWI and DCE-MRI parameters (D and Kep, r = 0.427, P = .027; D and Ve, r = 0.626, P <.001).IVIM-DWI is potentially useful for differentiating orbital malignant from benign tumors. Poor or moderate correlations exist between IVIM-DWI and DCE-MRI parameters. IVIM-DWI may be a useful adjunctive perfusion technique for the differential diagnosis of orbital tumors.
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Affiliation(s)
| | | | | | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Song J, Hu Q, Huang J, Ma Z, Chen T. Combining tumor size and diffusion-weighted imaging to diagnose normal-sized metastatic pelvic lymph nodes in cervical cancers. Acta Radiol 2019; 60:388-395. [PMID: 29911401 DOI: 10.1177/0284185118780903] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Detecting normal-sized metastatic pelvic lymph nodes (LNs) in cervical cancers, although difficult, is of vital importance. PURPOSE To investigate the value of diffusion-weighted-imaging (DWI), tumor size, and LN shape in predicting metastases in normal-sized pelvic LNs in cervical cancers. MATERIAL AND METHODS Pathology confirmed cervical cancer patients with complete magnetic resonance imaging (MRI) were documented from 2011 to 2016. A total of 121 cervical cancer patients showed small pelvic LNs (<5 mm) and 92 showed normal-sized (5-10 mm) pelvic LNs (39 patients with 55 nodes that were histologically metastatic, 53 patients with 71 nodes that were histologically benign). Preoperative clinical and MRI variables were analyzed and compared between the metastatic and benign groups. RESULTS LN apparent diffusion coefficient (ADC) values and short-to-long axis ratios were not significantly different between metastatic and benign normal-sized LNs (0.98 ± 0.15 × 10-3 vs. 1.00 ± 0.18 × 10-3 mm2/s, P = 0.45; 0.65 ± 0.16 vs. 0.64 ± 0.16, P = 0.60, respectively). Tumor ADC value of the metastatic LNs was significantly lower than the benign LNs (0.98 ± 0.12 × 10-3 vs. 1.07 ± 0.21 × 10-3 mm2/s, P = 0.01). Tumor size (height) was significantly higher in the metastatic LN group (27.59 ± 9.18 mm vs. 21.36 ± 10.40 mm, P < 0.00). Spiculated border rate was higher in the metastatic LN group (9 [16.4%] vs. 3 [4.2%], P = 0.03). Tumor (height) combined with tumor ADC value showed the highest area under the curve of 0.702 ( P < 0.00) in detecting metastatic pelvic nodes, with a sensitivity of 59.1% and specificity of 78.8%. CONCLUSIONS Tumor DWI combined with tumor height were superior to LN DWI and shape in predicting the metastatic state of normal-sized pelvic LNs in cervical cancer patients.
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Affiliation(s)
- Jiacheng Song
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Qiming Hu
- Department of Obstetrics & Gynecology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Junwen Huang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Zhanlong Ma
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Ting Chen
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Xu XQ, Qian W, Hu H, Su GY, Liu H, Shi HB, Wu FY. Histogram analysis of dynamic contrast-enhanced magnetic resonance imaging for differentiating malignant from benign orbital lymphproliferative disorders. Acta Radiol 2019; 60:239-246. [PMID: 29804475 DOI: 10.1177/0284185118778873] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has been used for assessing orbital lymphoproliferative disorders (OLPDs). However, only the mean values of quantitative parameters were obtained in previous studies and tumor heterogeneity was ignored. PURPOSE To assess the value of DCE-MRI derived histogram parameters in differentiating malignant from benign OLPDs. MATERIAL AND METHODS Forty-eight OLPDs patients (25 malignant and 23 benign) who had undergone DCE-MRI for pre-treatment evaluation were retrospectively included. Histogram parameters of Ktrans, kep, and ve were calculated and compared between two groups using the independent sample's t-test. Receiver operating characteristic (ROC) curve analyses were used to determine the diagnostic value of each significant parameter. Multivariate stepwise logistic regression analysis was used to identify the independent predictors of malignant OLPDs. RESULTS Tenth kep, mean kep, median kep, and 90th kep were significantly higher in the malignant OLPD group than in the benign OLPD group. Tenth ve was significantly lower in the malignant OLPD group than in the benign OLPD group. Ninetieth kep was the only independent predictor of malignant OLPDs ( P = 0.019), with an area under ROC curve of 0.828, a sensitivity of 92.00%, and a specificity of 78.26% at a cut-off value of 1.057 min-1. CONCLUSION Histogram analysis of DCE-MRI derived parameters may help to differentiate malignant from benign OLPDs. The 90th kep hold the potential as an independent predictor for malignant OLPDs.
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Affiliation(s)
- Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Wen Qian
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guo-Yi Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai-Bin Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Ren J, Yuan Y, Wu Y, Tao X. Differentiation of orbital lymphoma and idiopathic orbital inflammatory pseudotumor: combined diagnostic value of conventional MRI and histogram analysis of ADC maps. BMC Med Imaging 2018; 18:6. [PMID: 29716527 PMCID: PMC5930683 DOI: 10.1186/s12880-018-0246-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 01/21/2018] [Indexed: 12/25/2022] Open
Abstract
Background The overlap of morphological feature and mean ADC value restricted clinical application of MRI in the differential diagnosis of orbital lymphoma and idiopathic orbital inflammatory pseudotumor (IOIP). In this paper, we aimed to retrospectively evaluate the combined diagnostic value of conventional magnetic resonance imaging (MRI) and whole-tumor histogram analysis of apparent diffusion coefficient (ADC) maps in the differentiation of the two lesions. Methods In total, 18 patients with orbital lymphoma and 22 patients with IOIP were included, who underwent both conventional MRI and diffusion weighted imaging before treatment. Conventional MRI features and histogram parameters derived from ADC maps, including mean ADC (ADCmean), median ADC (ADCmedian), skewness, kurtosis, 10th, 25th, 75th and 90th percentiles of ADC (ADC10, ADC25, ADC75, ADC90) were evaluated and compared between orbital lymphoma and IOIP. Multivariate logistic regression analysis was used to identify the most valuable variables for discriminating. Differential model was built upon the selected variables and receiver operating characteristic (ROC) analysis was also performed to determine the differential ability of the model. Results Multivariate logistic regression showed ADC10 (P = 0.023) and involvement of orbit preseptal space (P = 0.029) were the most promising indexes in the discrimination of orbital lymphoma and IOIP. The logistic model defined by ADC10 and involvement of orbit preseptal space was built, which achieved an AUC of 0.939, with sensitivity of 77.30% and specificity of 94.40%. Conclusions Conventional MRI feature of involvement of orbit preseptal space and ADC histogram parameter of ADC10 are valuable in differential diagnosis of orbital lymphoma and IOIP.
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Affiliation(s)
- Jiliang Ren
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Yuan
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingwei Wu
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaofeng Tao
- 0000 0004 0368 8293grid.16821.3cDepartment of Radiology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Guo J, Liu Z, Shen C, Li Z, Yan F, Tian J, Xian J. MR-based radiomics signature in differentiating ocular adnexal lymphoma from idiopathic orbital inflammation. Eur Radiol 2018; 28:3872-3881. [PMID: 29632999 DOI: 10.1007/s00330-018-5381-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 02/06/2018] [Accepted: 02/08/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To assess the value of the MR-based radiomics signature in differentiating ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI). METHODS One hundred fifty-seven patients with pathology-proven OAL (84 patients) and IOI (73 patients) were divided into primary and validation cohorts. Eight hundred six radiomics features were extracted from morphological MR images. The least absolute shrinkage and selection operator (LASSO) procedure and linear combination were used to select features and build radiomics signature for discriminating OAL from IOI. Discriminating performance was assessed by the area under the receiver-operating characteristic curve (AUC). The predictive results were compared with the assessment of radiologists by chi-square test. RESULTS Five radiomics features were included in the radiomics signature, which differentiated OAL from IOI with an AUC of 0.74 and 0.73 in the primary and validation cohorts respectively. There was a significant difference between the classification results of the radiomics signature and those of a radiology resident (p < 0.05), although there was no significant difference between the results of the radiomics signature and those of a more experienced radiologist (p > 0.05). CONCLUSIONS Radiomics features have the potential to differentiate OAL from IOI. KEY POINTS • Clinical and imaging findings of OAL and IOI often overlap, which makes diagnosis difficult. • Radiomics features can potentially differentiate OAL from IOI non invasively. • The radiomics signature discriminates OAL from IOI at the same level as an experienced radiologist.
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Affiliation(s)
- Jian Guo
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
| | - Zhenyu Liu
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, 100190, China
| | - Chen Shen
- School of Life Science and Technology, Xidian University, Xi'an, Shanxi, 710126, China
| | - Zheng Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
| | - Fei Yan
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China
| | - Jie Tian
- CAS Key Laboratory of Molecular Imaging, Institute of Automation, Beijing, 100190, China. .,University of Chinese Academy of Sciences, Beijing, 100049, China.
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, No. 1 of Dongjiaominxiang, Dongcheng District, Beijing, 100730, China.
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Characterization of diffuse orbital mass using Apparent diffusion coefficient in 3-tesla MRI. Eur J Radiol Open 2018; 5:52-57. [PMID: 29719859 PMCID: PMC5926269 DOI: 10.1016/j.ejro.2018.03.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/02/2018] [Accepted: 03/11/2018] [Indexed: 01/28/2023] Open
Abstract
Purpose To evaluate if the apparent diffusion coefficient (ADC) value in diffusion-weighted magnetic resonance imaging (DW-MRI) improves the diagnostic accuracy of diffuse orbital masses. Materials and methods ADC DW-MRI was used to evaluate cases of diffuse orbital masses at our institution from 2000 to 2015. Lesions were grouped according to histopathologic diagnosis as, benign, pre-malignant and malignant. Lymphoproliferative lesions were further subgrouped as lymphoma or other lymphoproliferative lesions. The validity of the ADC value for the diffuse orbital mass was compared between groups. The area under curve (AUC) was also calculated. Results Thirty-nine cases of diffuse orbital masses were evaluated. The median ADC was 0.58 (25% quartile 0.48; minimum: 0.45; maximum: 1.72 × 10(−3)) for the malignant tumors and 1.19 (25% quartile 0.7; minimum: 0.5; maximum: 1.95 × 10(−3) mm(2) s(−1)) for benign lesions. This difference in ADC between lesions was statistically significant (Mann Whitney U test P < 0.001). The median ADC was 0.51 (25% quartile 0.48) for lymphomas and 0.9 (25% quartile 0.7) for other lymphoproliferative lesions. This difference in ADC was statistically significant (Mann Whitney U test P = 0.02). An ADC value of 0.8 × 10(−3) mm(2) s(−1) was noted as the ideal threshold value for differentiating malignant from benign diffuse orbital masses. The validity of ADC in predicting a malignant or benign diffuse orbital mass had a sensitivity of 87%, specificity of 67% and accuracy of 88%. Conclusion ADC is a promising imaging metric to characterize malignant and benign diffuse orbital masses and to distinguish lymphomas from other non−lymphoproliferative lesions.
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Lecler A, Savignac A. In Response to the Letter to the Editor Regarding “Optic Nerve Meningioma Mimicking Cavernous Hemangioma”. World Neurosurg 2018; 111:436. [DOI: 10.1016/j.wneu.2017.12.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 12/19/2017] [Indexed: 10/18/2022]
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Lecler A, Savatovsky J, Balvay D, Zmuda M, Sadik JC, Galatoire O, Charbonneau F, Bergès O, Picard H, Fournier L. Repeatability of apparent diffusion coefficient and intravoxel incoherent motion parameters at 3.0 Tesla in orbital lesions. Eur Radiol 2017; 27:5094-5103. [PMID: 28677061 PMCID: PMC5674133 DOI: 10.1007/s00330-017-4933-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 06/06/2017] [Accepted: 06/07/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To evaluate repeatability of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) parameters in the orbit. METHODS From December 2015 to March 2016, 22 patients were scanned twice using an IVIM sequence with 15b values (0-2,000 s/mm2) at 3.0T. Two readers independently delineated regions of interest in an orbital mass and in different intra-orbital and extra-orbital structures. Short-term test-retest repeatability and inter-observer agreement were assessed using the intra-class correlation coefficient (ICC), the coefficient of variation (CV) and Bland-Altman limits of agreements (BA-LA). RESULTS Test-retest repeatability of IVIM parameters in the orbital mass was satisfactory for ADC and D (mean CV 12% and 14%, ICC 95% and 93%), poor for f and D*(means CV 43% and 110%, ICC 90% and 65%). Inter-observer repeatability agreement was almost perfect in the orbital mass for all the IVIM parameters (ICC = 95%, 93%, 94% and 90% for ADC, D, f and D*, respectively). CONCLUSIONS IVIM appeared to be a robust tool to measure D in orbital lesions with good repeatability, but this approach showed a poor repeatability of f and D*. KEY POINTS • IVIM technique is feasible in the orbit. • IVIM has a good-acceptable repeatability of D (CV range 12-25 %). • IVIM interobserver repeatability agreement is excellent (ICC range 90-95 %). • f or D* provide higher test-retest and interobserver variabilities.
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Affiliation(s)
- Augustin Lecler
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France.
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France.
| | - Julien Savatovsky
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Daniel Balvay
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France
| | - Mathieu Zmuda
- Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Jean-Claude Sadik
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Olivier Galatoire
- Department of Orbitopalpebral Surgery, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Frédérique Charbonneau
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Olivier Bergès
- Department of Radiology, Fondation Ophtalmologique Adolphe de Rothschild, 29 rue Manin, 75019, Paris, France
| | - Hervé Picard
- Clinical Research Unit, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
| | - Laure Fournier
- Université Paris Descartes Sorbonne Paris Cité, INSERM UMR-S970, Cardiovascular Research Centre - PARCC, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Européen Georges Pompidou, Radiology Department, Université Paris Descartes Sorbonne Paris Cité, Paris, France
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Xu X, Wang Y, Hu H, Su G, Liu H, Shi H, Wu F. Readout-segmented echo-planar diffusion-weighted imaging in the assessment of orbital tumors: comparison with conventional single-shot echo-planar imaging in image quality and diagnostic performance. Acta Radiol 2017; 58:1457-1467. [PMID: 28330373 DOI: 10.1177/0284185117695667] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Readout-segmented echo-planar imaging (RS-EPI) could improve the imaging quality of diffusion-weighted imaging (DWI) in various organs. However, whether it could improve the imaging quality and diagnostic performance for the patients with orbital tumors is still unknown. Purpose To compare the image quality and diagnostic performance of RS-EPI DWI with that of conventional single-shot EPI (SS-EPI) DWI in patients with orbital tumors. Material and Methods SS-EPI and RS-EPI DW images of 32 patients with pathologically diagnosed orbital tumors were retrospectively analyzed. Qualitative imaging parameters (imaging sharpness, geometric distortion, ghosting artifacts, and overall imaging quality) and quantitative imaging parameters (apparent diffusion coefficient [ADC], signal-to-noise ratio [SNR], contrast, and contrast-to-noise ratio [CNR]) were assessed by two independent radiologists, and compared between SS-EPI and RS-EPI DWI. Receiver operating characteristic curves were used to determine the diagnostic value of ADC in differentiating malignant from benign orbital tumors. Results RS-EPI DW imaging produced less geometric distortion and ghosting artifacts, and better imaging sharpness and overall imaging quality than SS-EPI DWI (for all, P < 0.001). Meanwhile, RS-EPI DWI produced significantly lower SNR ( P < 0.001) and ADC ( P < 0.001), and higher contrast ( P < 0.001) than SS-EPI DWI, while producing no difference in CNR ( P = 0.137). There was no significant difference on the diagnostic performance between SS-EPI and RS-EPI DWI, when using ADC as the differentiating index ( P = 0.529). Conclusion Compared with SS-EPI, RS-EPI DWI provided significantly better imaging quality and comparable diagnostic performance in differentiating malignant from benign orbital tumors.
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Affiliation(s)
- Xiaoquan Xu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yanjun Wang
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hao Hu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guoyi Su
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hu Liu
- Department of Ophthalmology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Haibin Shi
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Feiyun Wu
- Department of Radiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Xu XQ, Qian W, Ma G, Hu H, Su GY, Liu H, Shi HB, Wu FY. Combined diffusion-weighted imaging and dynamic contrast-enhanced MRI for differentiating radiologically indeterminate malignant from benign orbital masses. Clin Radiol 2017; 72:903.e9-903.e15. [PMID: 28501096 DOI: 10.1016/j.crad.2017.04.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 03/30/2017] [Accepted: 04/10/2017] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the performance of the combination of diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) for differentiating radiologically indeterminate malignant from benign orbital masses. MATERIALS AND METHODS Sixty-five patients with orbital masses (36 benign and 29 malignant) underwent DW and DCE MRI examinations for pre-treatment evaluation. The apparent diffusion coefficient (ADC) was derived from DW imaging data using the mono-exponential model. The volume transfer constant (Ktrans), the flux rate constant between the extravascular extracellular space and the plasma (Kep), and the extravascular extracellular volume fraction (Ve) were calculated using modified Tofts model. Differences in quantitative metrics were tested using independent-samples t test. Receiver operating characteristic (ROC) curve analyses were used to determine and compare the diagnostic ability of each significant metric. RESULTS The malignant group demonstrated significantly lower ADC (0.711±0.260 versus 1.187±0.389, p<0.001) and higher Kep values (1.265±0.637 versus 0.871±0.610, p=0.008) than the benign group. Optimal diagnostic performance (area under the ROC curve [AUC], 0.941; sensitivity, 0.966; specificity, 0.917) could be achieved using combined ADC and Kep values as the diagnostic index. The diagnostic performance of the combination of ADC and Kep was significantly better than Kep alone (p=0.006). Compared with ADC alone, combined ADC and Kep values also showed higher AUC (0.941 versus 0.898), although the difference did not reach statistical significance (p=0.220). CONCLUSION Kep and ADC could help to differentiate radiologically indeterminate malignant from benign orbital masses. The combination of DW and DCE MRI might improve the differentiating performance.
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Affiliation(s)
- X-Q Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - W Qian
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - G Ma
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - G-Y Su
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - H-B Shi
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - F-Y Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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Qian W, Xu XQ, Hu H, Su GY, Wu JF, Shi HB, Wu FY. Dynamic contrast-enhanced MRI in orbital lymphoproliferative disorders: Effects of region of interest selection methods on time efficiency, measurement reproducibility, and diagnostic ability. J Magn Reson Imaging 2017; 47:1298-1305. [PMID: 28922524 DOI: 10.1002/jmri.25859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 09/05/2017] [Indexed: 01/22/2023] Open
Affiliation(s)
- Wen Qian
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing P.R. China
| | - Xiao-Quan Xu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing P.R. China
| | - Hao Hu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing P.R. China
| | - Guo-Yi Su
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing P.R. China
| | | | - Hai-Bin Shi
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing P.R. China
| | - Fei-Yun Wu
- Department of Radiology; First Affiliated Hospital of Nanjing Medical University; Nanjing P.R. China
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Sun B, Song L. Orbital malignant lesions in adults: multiparametric MR imaging. Jpn J Radiol 2017; 35:454-462. [DOI: 10.1007/s11604-017-0653-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 05/15/2017] [Indexed: 10/19/2022]
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Sun B, Song L, Wang X, Li J, Xian J, Wang F, Tan P. Lymphoma and inflammation in the orbit: Diagnostic performance with diffusion-weighted imaging and dynamic contrast-enhanced MRI. J Magn Reson Imaging 2016; 45:1438-1445. [PMID: 27649521 DOI: 10.1002/jmri.25480] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/29/2016] [Indexed: 11/11/2022] Open
Abstract
PURPOSE To investigate the diagnostic performance of diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), and the combination of both in the differential diagnosis of lymphoma and inflammation in the orbit. MATERIALS AND METHODS This retrospective study was approved by the Institutional Review Board and the informed consent requirement was waived. A total of 53 patients underwent preoperative 3T MRI. Parameters of DWI and DCE MRI were evaluated in these 30 patients with orbital lymphoma and 23 patients with orbital inflammation. The diagnostic performance was evaluated using receiver operating characteristic curve analysis. RESULTS Apparent diffusion coefficient (ADC) values and parameters derived from DCE MRI of orbital lymphoma and orbital inflammation differed significantly (ADC, Tmax , contrast index [CI], enhancement ratio [ER], and washout ratio [WR]: P < 0.001, P = 0.008, P < 0.001, P < 0.001, and P = 0.005 for reviewer 1, respectively; P < 0.001, P = 0.004, P < 0.001, P < 0.001, and P < 0.001 for reviewer 2, respectively). Sensitivity, specificity, and accuracy values of DWI were 76.67%, 100%, and 86.79% for reviewer 1; 70%, 95.65%, and 81.13% for reviewer 2, respectively. The combination of both were 90%, 86.96%, and 88.68% for reviewer 1; 93.33%, 78.26%, and 86.79% for reviewer 2, respectively. The combination of both was significantly superior to DWI for differentiation of orbital lymphoma from orbital inflammation (P = 0.016 for reviewer 1; P = 0.001 for reviewer 2). CONCLUSION The combination of DWI and DCE MRI can improve diagnostic performance in differentiating lymphoma from inflammation in the orbit compared with DWI alone. LEVEL OF EVIDENCE 3 J. MAGN. RESON. IMAGING 2017;45:1438-1445.
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Affiliation(s)
- Bo Sun
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Liyuan Song
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xinyan Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Feifei Wang
- Department of Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Pan Tan
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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